Ambrosini-Spaltro A, Dal Cappello T, Deluca J, Carriere C, Mazzoleni G, Eisendle K
Pathology Unit, Central Hospital Bolzano, Bolzano, Italy.
Cancer Registry of South Tyrol, Bolzano, Italy.
J Eur Acad Dermatol Venereol. 2015 Feb;29(2):243-248. doi: 10.1111/jdv.12501. Epub 2014 Mar 31.
Cutaneous melanoma incidence is increasing worldwide, especially for in situ and thin (<1 mm) lesions, while thick (≥1 mm) lesions have been generally stable in many studies; although epidemiological data on melanoma is readily available, population-based studies, especially on mountain regions, are rare.
The aim of this study was to analyse cutaneous melanoma incidence and Breslow tumour thickness in the central Alpine mountain region of South Tyrol, northern Italy.
All newly diagnosed cutaneous in situ and invasive melanomas in the resident population from 1998 to 2012 were taken from the Pathology Unit, Bolzano Hospital and South Tyrol Cancer Registry. Incidence and Breslow tumour thickness were analyzed. Statistical analyses included Mann-Whitney and Kruskal-Wallis tests.
A total of 784 in situ melanomas and 1663 invasive melanomas were collected. In situ melanomas showed the highest increase: European age-standardized incidence rose from 2.44 per 100,000 inhabitants in 1998-2002 to 16.01 in 2008-2012. Invasive melanoma incidence increased from 12.69 in 1998-2002, to 22.88 in 2008-2012. The incidence rise was observed in thin melanomas (from 8.39 to 16.18) and in thick melanomas (from 4.30 to 6.70). Breslow distribution revealed a median value of 0.62 mm (mean 1.34; SD 2.24; range 0.09-30.0) and did not change significantly over time (P = 0.286). Higher Breslow values were observed at advanced age (P < 0.001), among males (P = 0.017), in nodular melanomas (P < 0.001) and at higher Clark levels (P < 0.001). Significant differences were also found in urban hospitals compared to rural hospitals during the whole period (P = 0.004), but not in the last 5 years (P = 0.053).
Incidence of cutaneous melanoma is increasing in South Tyrol, especially for in situ and thin lesions, but also for thick lesions; no reduction in median tumour thickness is observed. Rural areas and elevated altitudes may contribute to this effect.
全球皮肤黑色素瘤发病率呈上升趋势，尤其是原位和薄型（<1mm）病变，而在许多研究中厚型（≥1mm）病变总体稳定；尽管黑色素瘤的流行病学数据很容易获得，但基于人群的研究，特别是关于山区的研究却很少。
本研究旨在分析意大利北部南蒂罗尔州中部阿尔卑斯山区皮肤黑色素瘤的发病率和布雷斯洛肿瘤厚度。
1998年至2012年常住居民中所有新诊断的原位和侵袭性皮肤黑色素瘤均来自博尔扎诺医院病理科和南蒂罗尔癌症登记处。分析发病率和布雷斯洛肿瘤厚度。统计分析包括曼-惠特尼检验和克鲁斯卡尔-沃利斯检验。
共收集到784例原位黑色素瘤和1663例侵袭性黑色素瘤。原位黑色素瘤的增长最为显著：欧洲年龄标准化发病率从1998 - 2002年的每10万居民2.44例上升至2008 - 2012年的16.01例。侵袭性黑色素瘤发病率从1998 - 2002年的12.69例升至2008 - 2012年的22.88例。薄型黑色素瘤（从8.39升至16.18）和厚型黑色素瘤（从4.30升至6.70）的发病率均有所上升。布雷斯洛分布的中位数为0.62mm（均值1.34；标准差2.24；范围0.09 - 30.0），且随时间无显著变化（P = 0.286）。高龄（P < 0.001）、男性（P = 0.017）、结节状黑色素瘤（P < 0.001）及较高的克拉克分级（P < 0.001）时布雷斯洛值较高。在整个研究期间，城市医院与农村医院相比也存在显著差异（P = 0.004），但在最后5年差异不显著（P = 0.053）。
南蒂罗尔州皮肤黑色素瘤发病率呈上升趋势，尤其是原位和薄型病变，厚型病变也如此；未观察到肿瘤厚度中位数降低。农村地区和高海拔地区可能对此有影响。
